Showing papers by "Richard F. Spaide published in 2007"
226 citations
TL;DR: Twenty-three-gauge instrumentation is effective for a variety of vitreoretinal surgical indications and the safety profile compared favorably with published rates for 25- gauge systems.
209 citations
TL;DR: In this article, the authors evaluated the change in visual acuity and retinal appearance in patients after early initiation of intravitreal bevacizumab treatment for central retinal vein occlusion.
119 citations
TL;DR: The findings suggest the vasculopathic and prothrombotic risks in some patients may not be addressed adequately by antithrombosis therapy, and suggest that the pathogenesis of CRVO may be more complicated than just the development of a primary thrombus within the vein.
99 citations
TL;DR: Treatment of RAP with intravitreal bevacizumab during this retrospective review resulted in a significant decrease in macular thickness and improvement or stabilization of visual acuity, which is warranted given the promising short-term results.
Abstract: OBJECTIVE To evaluate the short-term visual acuity and anatomic responses after intravitreal bevacizumab (Avastin, Genentech) treatment in patients with retinal angiomatous proliferation (RAP). METHODS The authors conducted a retrospective review of consecutive patients with newly diagnosed or recurrent RAP treated with intravitreal bevacizumab (1.25 mg) during a 3-month period. Complete ocular examination was performed at baseline and follow-up visits. Interval data were analyzed statistically at 1 and 3 months follow-up. RESULTS Twenty-three eyes of 23 patients underwent intravitreal bevacizumab treatment. The mean age of patients was 81.1 years, median baseline visual acuity of treated eyes was 20/80 (range 20/25-20/800), and mean baseline central macular thickness was 335 mum (optical coherence tomography was available for 22 eyes). Nine eyes had retinal pigment epithelial detachments (PEDs) at baseline. At 1-month follow-up, the median acuity improved to 20/60 (range 20/30-20/400) (P < 0.001), mean central macular thickness decreased to 202 microm (P < 0.001), and PED was present in only 2 eyes (P = 0.016). Seven of 23 eyes at 1 month (30.4%) had improved visual acuity, defined as halving of the visual angle, and no eyes had worse acuity, defined as doubling of the visual angle. Of the 17 eyes available for 3-month follow-up, 5 eyes (29.4%) had better visual acuity, 1 eye (5.9%) had worse acuity, and the remaining 11 (64.7%) had the same acuity. The median visual acuity at month 3 was 20/60 (range 20/25-20/400). There were no thromboembolic phenomena, endophthalmitis cases, retinal detachments, or any other adverse events. CONCLUSION Treatment of RAP with intravitreal bevacizumab during this retrospective review resulted in a significant decrease in macular thickness and improvement or stabilization of visual acuity. Further long-term investigation is warranted given the promising short-term results.
87 citations
TL;DR: These short-term results support the use of intravitreal bevacizumab for the management of CNV in patients with PXE and continue to establish its longer-term efficacy to define the potential need for serial injections to maintain these results.
Abstract: PURPOSE To determine the results of intravitreal bevacizumab injections for the management of choroidal neovascularization (CNV) in patients with pseudoxanthoma elasticum (PXE)-associated angioid streaks. METHODS A consecutive series of patients with PXE and CNV were managed with intravitreal bevacizumab injection (1.25 mg per 0.05 cc). The main outcome measures were visual acuity and greatest lesion height as measured by optical coherence tomography (OCT). RESULTS Nine eyes of nine consecutive patients received intravitreal bevacizumab (1.25 mg/0.05 mL) injections. The mean follow-up time was 6 months, during which eyes received an average of 1.8 injections. The baseline visual acuity was a mean of 20/368 and improved to 20/289 at the last visit (P = 0.056). Visual acuity either improved or stabilized in all 9 eyes (100%). Serial OCT measurements in 8 eyes showed a mean of 353 microm at baseline, which decreased to 201 mum at the last visit (P = 0.012). No complications were noted. CONCLUSIONS These short-term results support the use of intravitreal bevacizumab for the management of CNV in patients with PXE. Continued experience with intravitreal bevacizumab in this population will help establish its longer-term efficacy and better define the potential need for serial injections to maintain these results.
81 citations
01 Jan 2007
TL;DR: Fundus Autofluorescence Imaging with the Confocal Scanning Laser Ophthalmoscope and Macular Pigment Measurement - Clinical Applications and Perspectives in Imaging Technologies.
Abstract: Methodology.- Lipofuscin of the Retinal Pigment Epithelium.- Origin of Fundus Autofluorescence.- Fundus Autofluorescence Imaging with the Confocal Scanning Laser Ophthalmoscope.- How To Obtain the Optimal Fundus Autofluorescence Image with the Confocal Scanning Laser Ophthalmoscope.- Autofluorescence Imaging with the Fundus Camera.- Macular Pigment Measurement-Theoretical Background.- Macular Pigment Measurement -Clinical Applications.- Evaluation of Fundus Autofluorescence Images.- Clinical Application.- Macular and Retinal Dystrophies.- Discrete Lines of Increased Fundus Autofluorescence in Various Forms of Retinal Dystrophies.- Age-Related Macular Degeneration I-Early Manifestation.- Age-Related Macular Degeneration II-Geographic Atrophy.- Age-Related Macular Degeneration III-Pigment Epithelium Detachment.- Age-Related Macular Degeneration IV-Choroidal Neovascularization (CNV).- Idiopathic Macular Telangiectasia.- Chorioretinal Inflammatory Disorders.- Autofluorescence from the Outer Retina and Subretinal Space.- Miscellaneous.- Perspectives in Imaging Technologies.- Perspectives in Imaging Technologies.
74 citations
TL;DR: The induced anatomic changes noted in patients with idiopathic parafoveal telangiectasis suggest that there is a loss of the structural aspects afforded by Muller cells, particularly the Muller cell cone, in the central macula in Patients with IPT.
Abstract: Purpose To describe the macular holes in patients with idiopathic parafoveal telangiectasis (IPT) and to propose a pathophysiologic explanation for their formation. Methods Four eyes of two patients with IPT were evaluated with biomicroscopy and optical coherence tomography (OCT). Results One patient had a nearly full-thickness hole with preservation of only the internal limiting membrane (ILM), but had a 20/60 visual acuity. The other patient had a large full-thickness macular hole, but retained 20/40 visual acuity. Each patient had a fellow eye showing prominent central inner foveal cavitation under a very thin ILM, which was devoid of associated tissue. Conclusions This report describes the findings of two patients with IPT who developed pronounced central foveal structural abnormalities. The induced anatomic changes noted in our patients suggest that there is a loss of the structural aspects afforded by Muller cells, particularly the Muller cell cone, in the central macula in patients with IPT. The preservation of good visual acuity in our patients implies that the holes were the result of lateral separation of the photoreceptors within the fovea and that there could not have been profound atrophy of the photoreceptors.
53 citations
TL;DR: Patients with ASPPC have autofluorescence abnormalities during the acute manifestations of the disorder that help in interpretation of the fluorescein angiographic findings.
Abstract: Purpose: To evaluate the autofluorescence findings of acute syphilitic posterior placoid chorioretinitis (ASPPC). Methods: Patients with ASPPC underwent complete ophthalmologic examinations, including biomicroscopy, fundus color photography, autofluorescence photography, and fluorescein angiography. Results: As expected, the patients had a yellowish lesion in the posterior pole. However, the lesion appeared to have two components, a diffuse placoid yellow discoloration at the level of the retinal pigment epithelium (RPE) and focal yellow spots that appeared to lie on the RPE. The diffuse placoid yellow color change at the RPE level showed a slight generalized increase in autofluorescence admixed with tiny spots of decreased autofluorescence. The yellow collections in front of the RPE were intensely hyperautofluorescent. The placoid area showed fluorescein staining, while the yellow deposits blocked the background fluorescence. Treatment of syphilis caused resolution of the placoid changes with associated improvement in the autofluorescence and fluorescein abnormalities. Conclusion: Patients with ASPPC have autofluorescence abnormalities during the acute manifestations of the disorder that help in interpretation of the fluorescein angiographic findings. We found evidence that the RPE is primarily involved and there does not appear to be choriocapillaris occlusion in early lesions.
32 citations
TL;DR: Ranibizumab therapy was associated with significant improvements in mean visual acuity and central macular thickness for the group of all patients and Macular thickness decrease was noted irrespective of previous bevacizumAB therapy.
Abstract: Purpose:To evaluate the short-term outcomes after intravitreal ranibizumab (Lucentis; Genentech, Inc., South San Francisco, CA) injection in patients with neovascular age-related macular degeneration.Methods:A review of data for consecutive patients who received intravitreal ranibizumab injection wa
30 citations
01 Jul 2007
TL;DR: The white dot syndromes are a heterogeneous group of rare inflammatory disorders affecting the retina, the retinal pigment epithelium, and the choroid that share an association with systemic infectious diseases.
Abstract: The white dot syndromes are a heterogeneous group of rare inflammatory disorders affecting the retina, the retinal pigment epithelium, and the choroid. Not all of these diseases actually cause white dots, but they all have unique lesions in the fundus. We describe acute posterior multifocal placoid pigment epitheliopathy, serpiginous choroiditis, birdshot chorioretinopathy, multifocal choroiditis with panuveitis, diffuse subretinal fibrosis syndrome, punctate inner choroidopathy, multiple evanescent white dot syndrome, and diffuse unilateral subacute neuroretinitis as the white dot syndromes in this review. Some of these conditions share an association with systemic infectious diseases. In addition, treatment of these diseases is similar. Some can be treated with immunosuppressive therapy. Other treatment options include laser photocoagulation, topical or systemic steroid therapy, photodynamic therapy, and, most recently, anti-vascular endothelial growth factor agents. The new development in treatment may alter the visual prognosis of the patients, leading to a better outcome in visual acuity.
TL;DR: These cases indicate that the control of capillary growth in patients with IPT is defective, but the presence of vessels alone does not cause a marked decrease in visual acuity.
Abstract: We report two cases with idiopathic parafoveolar telangiectasis (IPT) that showed a deep invasion of perifoveal capillaries within the substance of the fovea, obliterating the foveal avascular zone All four eyes revealed characteristic findings of IPT, but demonstrated a deep layer of telangiectatic capillaries occupying the expected region of the foveal avascular zone, with retention of relatively good visual acuity These cases indicate that the control of capillary growth in patients with IPT is defective, but the presence of vessels alone does not cause a marked decrease in visual acuity
IPT is an acquired retinal disorder consisting of bilateral deep proliferation of telangiectatic perifoveal capillaries through the depth of the parafoveolar macula, and also centripetally to an extent—in that patients with IPT have smaller foveal avascular zones (FAZs) than normal patients1 We report two patients with IPT who showed a deep invasion of perifoveal …
01 Jan 2007
TL;DR: De Holz, Frank G. as discussed by the authors, Schmitz-Valckenberg, Steffen | Spaide, Richard F. | Bird, Alan C., tienda de libros de Medicina, Libros de Radiologia - Radiology General
Abstract: Tienda online donde Comprar Atlas of Fundus Autofluorescence Imaging al precio 99,21 € de Holz, Frank G. | Schmitz-Valckenberg, Steffen | Spaide, Richard F. | Bird, Alan C., tienda de Libros de Medicina, Libros de Radiologia - Radiologia General
01 Jan 2007
TL;DR: Comparisons of fluorescence measurements acquired from a fundus camera with those from a scanning laser ophthalmoscope (SLO) camera revealed that fluorescence intensity varied as a function of the logarithmic concentration of the dye, independent of the actual dye used.
Abstract: BACKGROUND AND OBJECTIVES To compare the fluorescence measurements acquired from a fundus camera with those from a scanning laser ophthalmoscope (SLO) camera. MATERIALS AND METHODS The fundus camera and the SLO camera were used to capture images of 29 cuvettes each containing serially diluted sodium fluorescein dye in normal saline. The intensity levels of the resulting images were plotted as a function of concentration to compare the two cameras. Ten samples of serially diluted indocyanine green (ICG) dye in bovine serum were also measured. RESULTS Both cameras revealed that fluorescence intensity varied as a function of the logarithmic concentration of the dye, independent of the actual dye used, with expected decrease in fluorescence at very high concentrations of dye due to quenching of fluorescence. There were very small variations on repeated trials with the fundus camera, whereas the SLO camera exhibited marked variability, particularly at higher concentrations of dye. Measurements acquired with the SLO camera varied as a function of time, which did not occur with the fundus camera. The image averaging software on the SLO camera caused shifts in the grayscale values measured that depended on the initial amount of fluorescence measured in the raw samples. CONCLUSIONS Although these differences may cause modest qualitative differences in imaging the ocular fundus, the variation in data obtained from the SLO camera would seem problematic if quantification of the amounts of fluorescence is required.